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World J Gastroenterol. Mar 14, 2014; 20(10): 2564-2577
Published online Mar 14, 2014. doi: 10.3748/wjg.v20.i10.2564
Immune dysfunction in cirrhosis
Nora Sipeki, Peter Antal-Szalmas, Peter L Lakatos, Maria Papp
Nora Sipeki, Maria Papp, Institute of Medicine, Department of Gastroenterology, University of Debrecen, H-4032 Debrecen, Hungary
Peter Antal-Szalmas, Department of Laboratory Medicine, University of Debrecen, H-4032 Debrecen, Hungary
Peter L Lakatos, 1st Department of Medicine, Semmelweis University, H-1083 Budapest, Hungary
Author contributions: All authors contributed to the design, drafting and final approval/preparation of the article.
Supported by Janos Bolyai Research Scholarship of the Hungarian Academy of Sciences and Internal Research Grant of University of Debrecen
Correspondence to: Maria Papp, MD, PhD, Institute of Medicine, Division of Gastroenterology, University of Debrecen, Nagyerdei krt 98, H-4032 Debrecen, Hungary. papp.maria@med.unideb.hu
Telephone: +36-52-255152 Fax: +36-52-255152
Received: October 29, 2013
Revised: December 25, 2013
Accepted: January 20, 2014
Published online: March 14, 2014
Processing time: 134 Days and 8.9 Hours
Core Tip

Core tip: Innate and adaptive immune dysfunction, also referred to as cirrhosis-associated immune dysfunction syndrome, plays a pivotal role in the pathogenesis of cirrhosis in both acute and chronic disease progression. During progression, acute decompensation is associated with organ failure(s), the so-called acute-on chronic liver failure, and chronic decompensation with progression of liver fibrosis and development of disease specific complications comprise distinct clinical entities with different immunopathology mechanisms. Enhanced bacterial translocation associated with systemic endotoxemia and systemic bacterial infections have substantial impacts in both clinical situations. In this review the authors provide overview of immune dysfunction and its consequences in cirrhosis.